The US Public Health Profile Library defines the conformance requirements for public health FHIR implementation guides in conjunction with US Core. It provides guidance for systems implementing public health requirements that extend beyond US Core and, in combination with US Core provides a foundation for additional US Realm Public Health FHIR HL7 implementation guides.

All US Realm Public Health FHIR based projects agree to the following language:

This FHIR implementation guide will use the US Public Health Profiles Library profiles. If this FHIR implementation guide is unable to reuse a US Public Health Profiles Library profile we will log a variance request to be dispositioned by the Public Health WG.

All variance requests will be discussed in the Public Health WG and voted upon.  The requester will be invited to the Public Health WG meeting to represent the variance request and be informed of the decision. Variance request SHALL be specific on the deviation requested. For example, an approval to deviate on Must Support or other cardinality does not allow deviation on terminology. If a terminology variance is needed, it SHALL be specified in the variance request.

To log a deviation request:

  1. Create a new tracker against US Public Health Profiles Library
    1. Mark it as a 'comment' Tracker
    2. List specific profiles with links
    3. Detail the specific reasons you can not use the underlying US Public Health Profiles Library profile
    4. Note any terminology variances
  2. Email PHWG co-chairs with a link to your Variance JIRA issue.  As well, post to Zulip in the #PublicHealth (TODO - check stream) stream with the links to your JIRA issue.
  3. PHWG will provide a week to review the variance request and then will discuss the issue at the next scheduled PHWG meeting after that week of review. (If there is a need for urgency in the variance request, please inform the (TODO) co-chairs when you email them.)
    1. IG editors will receive a US Public Health Profiles Library conformance warning in the IG publisher (QA.html) on their IG.
    2. If the variance is approved, editor may suppress the warning by including reference to the tracker in the ignoreWarnings.txt file.
  4. At publication FMG will confirm that every US Public Health Profiles Library suppressed warning has an approved tracker reference.

NOTE: As PHWG receives numerous variance requests in a specific domain area, a blanket policy will be considered or a new requirement for US Public Health Profiles Library developed.

(TODO): PHWG endorsed these two exceptions to the variance process. No variance is required when:

  1. New or changed profiles are only found in the CI build version of US Public Health Profiles Library
  2. IG is publishing a Technical Correction with no profiles being changed

Last approved by PHWG: <date>

Consider adding a flow diagram for process.

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